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“I’M A BETTER MANAGER”
A biographic narrative study of the impact of personal trauma on the
professional lives of managers in the UK
AMY ARMSTRONG
Doctor of Philosophy
ASTON UNIVERSITY
May 2014
© Amy Armstrong, 2014
Amy Armstrong asserts her moral right to be identified as the author of this thesis.
This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and that no quotations from the thesis and no information derived from it may be published without appropriate permission or acknowledgement
Aston University
Thesis title: “I’m a better manager”: A biographic narrative study of the impact of personal trauma on the professional lives of managers in the UK
Name: Amy Armstrong Degree: Doctor of Philosophy Year of submission: 2014
This doctoral study aims to understand how experiences of critical illness or bereavement affect the way managers view and approach their work and their relationships at work. This is an interpretative phenomenological study examining the subjective meanings of personal experience and is underpinned by biographic narratives from four participants and interviews with their nominated workplace witnesses (i.e. colleagues who worked alongside the
individual at the time of their trauma).
As a consequence of the findings that have emerged across this study, three contributions to theory are presented. All four participants described their traumas as a professional growth experience for themselves as managers, which resulted in self-reported and observed behaviour change at work. Consequently, the first area of theoretical contribution is a suggested extension to the post-traumatic growth (PTG) framework (Calhoun & Tedeschi, 2006) with the addition of a new behavioural dimension called ‘managerial growth’, when applied to the context of ‘ordinary’ organizations.
The second area of theoretical contribution arose through the reflexive process that was created during data collection where participants and their witnesses remembered episodes of compassion interaction at work. The second area of contribution thus seeks to extend the existing model of compassion at work (Dutton, Worline, Frost and Lilius, 2006), by
conceptualising compassion as a dyadic process between a compassion ‘giver’ and a compassion ‘receiver’ in which the compassion receiver ‘trusts or ‘mistrusts’; ‘discloses’ or ‘withholds’; ‘connects’ or ‘disconnects’ with the compassion giver.
The third area of contribution is a new conceptualisation of reflexivity, ‘three-dimensional reflexivity’ (3DR) (Armstrong, Butler and Shaw, 2013). 3DR brings together three of the elements that have been missing from critically reflexive management research; by working with multiple variants of reflexivity in the same study; surfacing different reflexive voices to guard against the researcher’s (potentially) solipsistic own; and remaining sensitive to the concept of reflexive time. In doing so, 3DR not only provides a deeper understanding of individual lived experience; it is also a vehicle in which self-insight is gained. Furthermore, by engaging in its practice, those involved in this study have developed both personally and professionally as a result.
Key words: Biographic Narratives; Critical Narrative Analysis; Reflexivity; Positive Organizational Scholarship
“If you want to know me, then you must know my story, for my story defines who I am. And if I want to know myself, to gain insight into the meaning of my own life, then I, too must come
ACKNOWLEDGEMENTS
Contrary to most doctoral students whose PhD theses appear to weigh upon them like a mill stone, I am pleased that this thesis is six years in the making. In 2008, it began as a purpose, a way of channelling my suffering and my grief, but during these six years, my life has
changed beyond recognition and the reasons for beginning this journey are not the same reasons for drawing it to its completion. I began this thesis for Andy and for our 18 month old daughter Anna. I complete it for my wonderful Col and an indomitable seven year old!
Someone once said to me, without experiencing darkness, it is difficult to appreciate beauty and light and without my experience of personal trauma, this journey would never have begun. If Andy were to be able to read this work today, I hope he would see how determined I have been to turn his premature death and the suffering it caused into something positive. Through my doctoral studies, I have grown personally and professionally and I have begun to use the knowledge gained in this work to support the development of others.
Col, you are wonderful, giving and selfless and you have been unfaltering in your love and support for me despite the complicated nature of our lives. From our chats in the Greyhound; the reading of chapters; my ‘thinking aloud’ during our runs; and the countless nights and days you have supported and encouraged me to write, you are the reason that this thesis has been successfully drawn to its completion.
Anna, I hope that one day you will read this work and you will be proud of your Mum. I know that at times since you were born, I have been pre-occupied with my research, but I hope that by seeing the fruits of my labours, I show you my belief in the power of learning from life. I also hope that I am a positive role model to you of dedication and hard work.
Finally, this learning journey would not have been possible without support from my family, friends, my PhD supervisors Dr Rachel Shaw and Dr Michael Butler and my employer, Ashridge.
CONTENTS
1.
INTRODUCTION ... 10
1.1 Ideas of growth through trauma ... 11
1.2 Study aims and research question ... 13
1.3 Definitions ... 15
1.4 Personal narratives and growth through trauma research ... 18
1.5 Self-narratives in organizations ... 19
2.
SUMMARY OF THE QUALITATIVE LITERATURE ... 21
2.1 Growth through cancer ... 28
2.2 Growth through bereavement... 29
2.3 Growth among trauma workers ... 30
2.4 Areas of convergence ... 33
2.5 Critiquing the literature ... 34
3.
METHODOLOGICAL APPROACH ... 37
3.1 Introduction ... 37
3.2 The narrative turn ... 37
3.3 Personal experience narratives (PENs) ... 38
3.4 Analysing PENs ... 40
3.5 Biographic Narrative Interpretive Method (BNIM) ... 42
3.6 Interpretative Phenomenological Analysis (IPA) ... 47
3.7 Critical Narrative Analysis (CNA) ... 50
3.8 Embedding reflexivity into the research process ... 51
3.9 Ethical considerations ... 56
3.10 Research design ... 60
4. EDGAR ... 66
4.1 Introduction ... 67
4.2 Edgar’s self-presentation: A strong hard-working man ... 69
4.3 Exploring the themes in Edgar’s narrative ... 73
4.4 Edgar’s internal self: focusing on the PINs ... 78
4.5 Exploring third party views: Edgar’s workplace witnesses ... 84
4.6 Shared themes ... 88
4.7 Case synthesis ... 96
4.8 Reflexive critique ... 104
4.9 Adapting the methods ... 107
5.
BILL ... 114
5.1 Introduction ... 115
5.2 Bill’s self-presentation: a struggle for self-control ... 115
5.3 Exploring themes in Bill’s narrative... 120
5.4 Bill’s inner self: Focusing on the PINs ... 126
5.5 Exploring third party views: Bill’s workplace witnesses ... 128
5.6 Shared themes ... 133
5.7 Case synthesis ... 135
5.8 Reflexive critique ... 137
6.
DIANE ... 140
6.1 Introduction ... 141
6.2 Diane’s self-presentation: nowhere to grieve ... 141
6.3 Diane’s inner self: Focusing on the PINs ... 147
6.4 Exploring third party views: Diane’s workplace witnesses ... 149
6.6 Case synthesis ... 154
6.7 Reflexive critique ... 155
7.
PETER ... 158
7.1 Introduction ... 159
7.2 Peter’s self-presentation: trying to “work through it” ... 159
7.3 Exploring themes in Peter’s narrative ... 161
7.4 Peter’s inner self: Focusing on the PINs ... 166
7.5 Exploring third party views: Peter’s workplace witness ... 171
7.6 Case synthesis ... 174
7.7 Reflexive critique ... 177
8.
STUDY SYNTHESIS: THREE AREAS OF CONTRIBUTION ... 179
8.1 Introduction ... 179
8.2 Domains of post-traumatic growth ... 182
8.3 Extending the PTG framework ... 190
8.4 Extending the ‘noticing-feeling-responding’ model of compassion ... 192
8.5 Three-dimensional reflexivity (3DR) ... 204
9.
PRACTICAL IMPLICATIONS, LIMITATIONS AND FUTURE DIRECTIONS ... 220
9.1 Practical implications ... 220
9.2 Study limitations ... 225
9.3 Directions for future research ... 227
9.4 Conclusions ... 229
LIST OF FIGURES
Figure 1.1: Post-traumatic growth (PTG) framework (Calhoun and Tedeschi, 2006) ... 12
Figure 3.1: Critical Narrative Analysis (CNA) ( Langdridge, 2007) ... 51
Figure 3.2: Research design ... 61
Figure 3.3: Participant recruitment process ... 62
Figure 4.1: Key themes and layers of self at work (Edgar’s witness perspective) ... 85
Figure 4.2: Layers of self at work: convergent and divergent themes in Edgar’s case ... 96
Figure 4.3: Critical Narrative Analysis (CNA) (Langdridge, 2007) ... 110
Figure 4.4: Adapted CNA for subsequent case analysis ... 111
Figure 8.1: Three dimensional reflexivity (3DR) (Armstrong, Butler and Shaw, 2013) ... 181
Figure 8.2: Extended model of compassion at work ... 197
LIST OF TABLES
Table 2.1: Qualitative studies of post-traumatic growth through cancer ... 25Table 2.2: Qualitative studies of post-traumatic growth through bereavement... 27
Table 3.1: Ten Stages of BNIM analysis ... 46
Table 4.2: Tick-box comparison of the methods ... 108
Table 8.1: Domains of post-traumatic growth (participants and witnesses) ... 187
LIST OF APPENDICES ... 247
11.1 APPENDIX A: ETHICAL APPROVAL ... 247
11.2 APPENDIX B: CALL FOR PARTICIPATION ... 248
11.3 APPENDIX C: DETAIL OF STUDY PARTICIPANTS & WORKPLACE WITNESSES . 249 11.4 APPENDIX D: PARTICIPANT INFORMATION AND CONSENT SHEET ... 250
11.5 APPENDIX E: PARTICIPANT INTERVIEW GUIDES ... 252
11.6 APPENDIX F: WORKPLACE WITNESS INTERVIEW GUIDE ... 253
11.7 APPENDIX G: KEY TO TRANSCRIPTION ... 254
11.8 APPENDIX H: VERBATIM TRANSCRIPT EXAMPLE ... 255
11.9 APPENDIX I: RESEARCH DIARY EXTRACT ... 265
11.10 APPENDIX J: BIOGRAPHIC DATA CHRONOLOGY (BDC) AND TOLD STORY SEQUENCE (TSS) FOR PANEL (BNIM STAGES 2 AND 5) ... 271
11.11 APPENDIX K: EDGAR’S ‘LIVED LIFE’ PANEL 27/9/2011 (BNIM STAGE 3) ... 276
11.12 APPENDIX L: EDGAR’S ‘TOLD STORY’ PANEL 28/9/2011 (BNIM STAGE 6) ... 283
11.13 APPENDIX M: INTERPRETIVE PANEL SUMMARIES (STAGE 4 - IMAGINING) .... 290
11.14 APPENDIX N: EDGAR’S THEMES (BNIM STAGE 7) ... 294
11.15 APPENDIX O: WORKPLACE WITNESS INTERVIEW ANALYSIS: CAITLIN ... 300
11.16 APPENDIX P: WORKPLACE WITNESS INTERVIEW THEMES: CAITLIN ... 326
11.17 APPENDIX Q: IDENTIFYING BILL’S PINS ... 331
11.18 APPENDIX R: BILL TOLD STORY PANEL FLIPCHART NOTES ... 334
1.
INTRODUCTION
There are many ways in which an individual might suffer during the course of their personal lives and the difficulties that someone is facing is likely to have an impact on their work life given the ‘whole person’ goes to work (Ramarajan and Reid, 2013). This suffering ‘overspill’ has been found to have psychological, physiological and interpersonal implications for individuals at work (Frost, 2003), yet employers appear to know little about how to respond (Hall, Shucksmith and Russell, 2013; Hazen, 2008).
We are all likely to experience bereavement during the course of our lives. If mortality rates in England grow by the estimated 15% that is suggested by the ONS (2011) between now and 2035, and if each death leaves five people bereaved (Shear, Frank, Houck and Reynolds, 2005), the number of people affected by bereavement is likely to increase in the next two decades. In their survey of 4038 adults in the UK, Penny, Chapman and Levenson (2014) found that 32% of people who had been bereaved within the past five years and who were in a job at the time did not feel they had been treated with compassion by their employer. 56% of those surveyed saying that they would consider leaving their job if they were not treated compassionately.
In this regard, scholars within the field of positive organizational scholarship (Cameron, Dutton and Quinn, 2003), which focuses on the positive human processes in organizations, have been suggesting for some time that compassion at work is central to employee well-being (Dutton, Worline, Frost and Lilius, 2006; Frost, 1999; Kanov, Maitlis, Worline, Dutton, Frost and Lilius, 2004; Lilius, Worline, Maitlis, Kanov, Dutton and Frost, 2008; Lilius, Worline, Dutton, Kanov and Maitlis, 2011; Pace, 2010). Research has shown that compassion is linked to organizational commitment (Lilius et al, 2008) and that caring managers and caring colleagues are two of the most important predictors of organizational performance (Harter, Schmidt and Haynes, 2002). Furthermore, compassion at work builds relationships (Kanov et al, 2004) and creates connection and trust among colleagues (Dutton et al, 2006).
During our working life, individuals may also face experiences of critical illness. MacMillan UK (www.macmillan.org.uk) estimates that 1 in 3 people will develop some form of cancer within their lifetime, so the way in which employers respond to illness of this kind is another pressing concern for organizations in the UK.
Despite their suffering, some individuals see their trauma experiences as a catalyst for growth, learning and positive change. The idea that people can triumph over tragedy is not a new concept. Stories of individuals overcoming adversity have been well-documented in literature (e.g. Frankl, 2004). However, systematic academic studies of growth through trauma have only emerged within the past 20 years.
1.1
Ideas of growth through trauma
In 1999, the first Positive Psychology conference was held in the US. This movement was spearheaded by Martin Seligman and involved other leading scholars such as Ed Diener and Rick Snyder. The aim of the positive psychology movement, as articulated by Luthans
(2002), is:
“To shift the emphasis away from what is wrong with people to what is right with people – to focus on strengths (as opposed to weaknesses), to be interested in resilience (as opposed to vulnerability), and to be concerned with enhancing and developing wellness, prosperity and the good life (as opposed to the remediation of pathology).” (2002:697)
Within this movement, empirical studies of growth through trauma began in the 1990s, with many labels being used to describe self-reported positive individual change in the face of suffering. These terms(in chronological order) include; ‘post-traumatic growth’ (Tedeschi and Calhoun, 1996); ‘benefit-finding’ (Affleck and Tennen, 1996); stress-related growth’ (Park, Cohen, and Murch, 1996); ‘thriving’ (Carver, 1998; O’Leary, 1998; Saakvitne, Tennen and Affleck, 1998); ‘meaning as outcome,’ (Bower, Kemeny, Taylor and Fahey, 1998); flourishing’ (Keyes and Haidt, 2003); and ‘adversarial growth,’ (Linley and Joseph, 2004).
Empirical studies of growth through trauma within the field of positive psychology have taken place among multiple trauma types. Studies of critical illness include cancer, heart attack, brain injury, spinal cord injury, HIV/AIDS, rheumatoid arthritis and multiple sclerosis (see Linley and Joseph, 2004 for a review). Studies of traumatic life experiences include bereavement; divorce; and immigration (see Joseph, 2009 for a review).
Within positive psychology, three concepts relating to individual growth through trauma have emerged as the most cited theoretical constructs in the literature. These are stress-related growth (SRG) (Park, Cohen and Murch, 1996); benefit-finding and growth (BFG) (Lechner, Tennen and Affleck, 2009) and post-traumatic growth (PTG) (Calhoun and Tedeschi, 2006; Tedeschi and Calhoun, 1996) (see Figure 1.1.).
The concept of stress-related growth (SRG) is linked to earlier research into ‘cognitive adaptation’ following stressful events (e.g. Taylor, 1983). SRG is a construct that aims to capture shifts in an individual’s thinking and behaviour following a stressful situation. Benefit-finding and growth (BFG) has a similar aim, but was specifically developed for studies of growth through cancer, and like stress-related growth, has been found to have trait-based predictors e.g. optimism (Sears, Stanton and Danoff-Burg, 2003). BFG as a construct, however, appears to have problems in its conceptualisation, since some scholars challenge whether it is a coping process or an outcome of positive change. Some scholars assert that those who use benefit-finding as an underlying theory base rarely distinguish between the processes and outcomes of growth (Park and Helgeson, 2006).
Post-traumatic growth (PTG) on the other hand is described as a construct that explores growth processes and outcomes (Calhoun and Tedeschi, 2006) which results in cognitive transformation, learning and wisdom for the people who report growth following trauma. PTG, unlike the other two constructs described above, does not necessarily have trait-based predictors (Sears et al, 2003), and, if combined with doing something different as a result of trauma, PTG has been found to have different outcomes in terms of changed thinking and behaviours (Hobfoll, Hall, Canetti-Nisim, Galea, Johnson and Palmieri, 2007). That is to say, there is research that connects PTG with increased levels of distress unless actions ensue as a result of the coping process in order to mobilise the individual to achieve growth (e.g. Solomon and Dekel, 2007). This has been called ‘action-focused growth’ and has been suggested as a way to understand genuine post-traumatic growth (Hobfoll et al 2007). Figure 1.1: Post-traumatic growth (PTG) framework (Calhoun and Tedeschi, 2006)
This study focuses on PTG as an underlying theory base, since it is cited as the most dominant construct in the literature (Ramos and Leal, 2013). Furthermore, with recent calls for the framework to be extended to include explorations of behaviour change (Shakespeare-Finch and Barrington, 2012), it appears to be the most comprehensive framework within which to explore individual growth through trauma.
Research on post-traumatic growth has burgeoned in recent years, therefore it is surprising that very few studies have taken place within organizational contexts, and those that have, focus on professionals in ‘extremis’ settings (Kolditz and Brazil, 2005) where exposure to trauma is commonplace, such as disaster recovery workers, counsellors, emergency services personnel or the military. (For a review, see Cohen and Collins, 2012; Linley and Joseph, 2006; Paton, 2005; 2006.) Scholars within the field of positive organizational scholarship have called post-traumatic growth “a missed opportunity” (Maitlis, 2012:909) since little has been done to explore growth within everyday workplace contexts. As Maitlis argues:
“The richest opportunities lie in studies of growth in work settings not normally associated with trauma…given the sad inevitability of such experiences at work, POS [Positive Organizational Scholarship] can make a major contribution to the field of organizational behaviour by increasing our understanding of how and when growth can emerge out of such traumas” (2012:918-919)
The present study aims to exploit the missed opportunity that Maitlis (2012) speaks of by exploring experiences of personal trauma among managers working in ‘everyday’
organizations in the UK.
1.2
Study aims and research question
This study seeks to understand the impact of personal trauma on the professional lives of managers working in ‘everyday’ workplace contexts in the UK; that is to say, organizations in which experiences of trauma are not commonplace. The research question that this study seeks to address is:
How does the experience of personal trauma affect the way managers view and approach their work and their relationships at work?
This study sits within interpretative phenomenology, (e.g. Van Manen, 1990) where the researcher seeks to understand the subjective meanings of individual experience (Konrad,
2006). The present study is underpinned by biographic narratives, which are the individual trauma stories that are told. Within interpretative phenomenology, personal experience narratives are seen as connecting the inner and outer worlds of consciousness, as these stories are an attempt to describe the subjective meanings of personal experience (Wengraf, 2010).
Narrative research within the social sciences, according to Andrews, Squire and Tamboukou (2008) has its origins in two parallel academic movements. Both movements sought to examine language as a way of constructing realities and identities, which differs from positivist research which sees narratives merely as a means for collecting and interpreting data (Kohler Riessman, 2008). Poststructuralist approaches to narrative research, which emerged from 1970s onwards, focused on the structure and content of narratives that were seen to be constructed from within specific cultural contexts (e.g. Ricoeur, 1990). Humanist approaches to narrative research, on the other hand, began in the 1980s and were person-centred, often involving individual case studies, biographies and life histories (e.g. Bruner, 1990). In humanist approaches to narrative research, individual narratives are seen to represent a single unified identity, rather than poststructuralists who see narratives as social constructions between a teller and a listener, which can assume multiple identities and interpretations. This doctoral study implicitly adopts a poststructuralist standpoint, since the personal narratives in the present study are viewed as one story among many stories that may be told by the narrator about themselves and their trauma experience.
At this juncture, it is important to define the boundaries of this doctoral study. The present study is not a trait-based investigation. There are many studies which connect individual personality to growth through trauma (e.g. Affleck and Tennen, 1996; Aldwin, Sutton and Lachman, 1996; Park et al, 1996), as there are studies that explore the effects of particular types of trauma (e.g. Davis, Nolen-Hoeksema and Larson, 1998; Milam, 2006; Tedeschi and Calhoun, 2008; Weiss, 2005). Following these studies, the present study assumes that an individual’s personality is linked to his or her ability to cope with trauma, and that different types of trauma may induce different growth outcomes, however, that is not the focus of this enquiry.
Furthermore, the present study does not explore personal resilience as an underpinning concept within growth through trauma. The reason that resilience is not a specific route of enquiry is because it is often defined as an aspect of ‘recovery’ where the individual returns to their pre-trauma state. Luthans (2002) defines individual resilience as:
“The developable capacity to rebound or bounce back from adversity, conflict and failure”
(2002:702)
However, the present study is at odds with this definition as it assumes that individuals do not ‘recover’ from trauma by returning back to their original state. Instead, it is ideas of change (as opposed to resilience) that are present within an individual’s narrative that are explored in the present study. Furthermore, there appears to be some disagreement in the literature as to whether resilience is a process or an outcome, and whether it is a state (that is to say, it is capable of being developed), or a trait which is perceived to be immutable. Since this project does not explore personality traits and their relationship to individual growth, this is another reason why resilience is not a primary focus of enquiry. Lepore and Revenson (2006) instead argue for ‘reconfiguration’ as opposed to resilience, which is about individual adjustment as opposed to recovery and in the present study, ‘reconfiguration’ is described within the individual trauma stories that are told.
As a result of these aims and the research question, the present study adopted a flexible, inductive approach to enquiry which helped it to remain open to the findings that would emerge.
1.3
Definitions
1.3.1 Personal trauma
Until the positive psychology movement, studies of personal trauma appear to have been led by psychiatrists and clinical psychologists who were interested in studying the short and long-term psychopathological disorders resulting from a traumatic experience (e.g. post-traumatic stress disorder, depression, anxiety and substance abuse) for diagnostic and treatment purposes. It is for this reason, perhaps, that the definition of a traumatic event proposed by the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) is too narrow for the purposes of this study. They define a traumatic event as:
“Direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate.” (1994:424)
For the purposes of this study, personal trauma is more broadly defined as a life-changing event, judged by the individual themselves, to have been significant enough to shatter the foundations upon which their views of themselves and the world are based. As Janoff-Bulman (2006) clarifies:
“I would argue that it is not the recognizable, readily apparent external losses – of one’s health, home, community, or a loved one – that define an experience as traumatic, but rather the internal disorganization and disintegration that follows from our psychological
unpreparedness. Traumas are shocks to our inner worlds.” (2006:83)
Calhoun and Tedeschi (2006) suggest that if an event is traumatic, individuals seek to re-construct their life stories to take into account this life-changing experience:
“If a person refers to a negative event as a watershed that divides life into a ‘before and after’ the event, it has been traumatic.” (2006:9)
Given the fact that individual narratives underpin this doctoral study, it is important to provide an explanation of what is meant by the term ‘narrative’.
1.3.2 Personal narratives
Unfortunately, there is no single definition of the term ‘narrative’ and scholars across the fields of sociology, psychology and linguistics (to name but a few) appear divided as to the meaning of the term. This may be because narrative research spans a range of fields, methodological approaches and theory bases. As Smith and Sparkes (2008) warn:
“The range of theories has expanded in the past few decades and scholarship in this area has become increasingly complex, muddled, and difficult to stay appraised of” (2008:6)
The term ‘narrative’ can be seen as synonymous with ‘story’, especially if it includes some kind of disturbance that provokes a reaction or adjustment in the identity of the teller, (De Fina, 2003:13), in line with Calhoun and Tedeschi’s (2006) point above. Narratives,
according to Kohler Riessman are “everywhere, but not everything is narrative” (2008:4). She argues that due to the popularity of the term, anything beyond a few bullet points or a few spoken words is falsely labelled ‘narrative’. She argues that narratives, unlike other forms of communication, are written or told in the first person; set within a cultural context; contain an ordering of events and involve a display of emotions and meanings. She offers a specific
definition of a narrative:
“Events perceived by the speaker as important are selected, organized, connected and evaluated as meaningful for a particular audience.” (Kohler Riessman, 2008:3)
This quote privileges narratives as deliberate in their construction, that is to say, by “imposing
a meaningful pattern on otherwise disconnected ideas and events” (Kohler Riessman,
2008:5), it renders them meaningful for the audience who hears them. Other scholars, such as Labov (1972) only accept a piece of talk or text as a ‘complete’ narrative, if it comprises six constituent parts which make up the beginning, middle and end of the story. These are: the summary or abstract; orientation, (i.e. information about timings, places, situations and characters); action, (i.e. event sequences usually around a crisis or turning point); evaluation, (i.e. when the teller steps back to communicate their emotions and perceived meanings related to the event); resolution, (i.e. the outcome); and ‘coda’, or the ending of the story.
The Labovian (1972) definition may fall short however when it comes to personal trauma narratives. This is because individual trauma narratives can be “broken” (Hydén and Brockmeier, 2008:10) if the individual is not able to construct a coherent account of their experience. As these authors explain, ‘broken’ narratives are:
“told by people who in one way or another have trouble telling their stories, be it due to injury, disability, dementia, pain, grief, psychological or neurological trauma” (2008:10)
In growth through trauma research, some scholars argue that narrative coherence is
evidence of post-traumatic growth (e.g. Calhoun and Tedeschi, 2006; Janoff-Bulman, 2006; Neimeyer, 2006; Pals and McAdams, 2004). However, in some trauma narratives, the story that is told may emerge ‘in the moment’ of its telling as Ochs and Capps’ (1996) suggest:
“Personal narrative simultaneously is born out of experience and gives shape to experience. In this sense, narrative and self are inseparable. Self is here broadly understood to be an unfolding reflective awareness of being-in-the-world, including a sense of one’s past and future. We come to know ourselves as we use narrative to apprehend experiences and navigate relationships with others.” (1996:20)
This is another important aspect of the personal narratives that are told in the present study, where they are a means of constructing an individual’s sense of self. As Yuval Davis
“Identities are narratives, stories people tell themselves and others about who they are (and who they are not)” (2006:201)
In this doctoral study, personal experience narratives are seen as a means by which internal experiences, thoughts and feelings are given external expression (Andrews, Squire and Tamboukou, 2008:5) and to this end, there is an ‘evolving’ element to these narratives. They are a creative re-description of the world, told by the individual and then interpreted by the researcher, with the implication that there are many different ways to tell and interpret a story (e.g. Bury, 2001; Kohler Riessman, 2008; Rhodes and Brown, 2005). It is for this reason that personal narratives in this study are seen as a version of a story among many so as to present the ‘self’ we wish others to see (Langellier, 1989). Kohler Riessman (2008) summarises this view of narratives:
“We are forever composing impressions of ourselves, projecting a definition of who we are, and making claims about ourselves and the world that we test out and negotiate with others.”
(2008:106)
It is important that both personal trauma and personal narratives are defined from the outset, not only because they are the focus of this doctoral research, but also because personal narratives have been tied to the concept of post-traumatic growth (Neimeyer, 2006). The connection between personal narratives and growth is therefore the focus of the next section.
1.4
Personal narratives and growth through trauma research
It has been suggested that personal trauma narratives are implicitly tied to the coping and growth process, whereby the act of constructing a trauma story can be seen as a coping strategy (Niederhoffer and Pennebaker, 2009; Neiymeyer, 2006; Pals and McAdams, 2004); or the story itself may be a sign of post-traumatic growth, as it enables the individual to re-define themselves post-trauma (Baumeister, 1991; McAdams, 1996; Thorne, 2000). Some researchers suggest that the entire concept of post-traumatic growth is built on self-narrative. As Pals and McAdams (2004:65) explain:
“The life story should not be viewed as just one piece of the complex puzzle of post-traumatic growth, as Tedeschi and Calhoun’s model suggests, but rather as the fundamental frame that holds the entire puzzle together.”
Neimeyer (2006) argues that the desire to organise life events into a coherent narrative is one of the basic schematic structures of human thought. It has been argued that by talking
about trauma, this enables an individual to make sense of their experience and to communicate the meanings of this experience to others (Neiderhoffer and Pennebaker, 2009). In growth through trauma research, Pals and McAdams (2004) go further by outlining two specific steps in the narrative process. Firstly, they argue, there is an acknowledgement of the impact of trauma on the self, when an individual talks about the negative implications of the traumatic event as a way of shaping new ideas about themselves; and secondly, by constructing a positive end to the story, this helps the individual to explain how they have grown as a result of their experience.
1.5
Personal narratives in organizations
Given that the present study seeks to explore how experiences of personal trauma affect the way managers view and approach their work and their relationships at work, the personal narratives that emerge in the present study are not crafted from within a vacuum. The organizational contexts in which participants work are visible in their narratives and despite being positioned as “micro situational”, that is to say, a study in which the institutional context is not the primary unit of analysis (Grant, Iedema & Oswick, 2009:215); it is important
nonetheless to signal the influence of the organizational context on self-narrative. Some scholars, particularly those within the field of critical management studies suggest that there are dominant organizational discourses that affect the way in which individuals make sense of themselves at work (e.g. Alvesson, 2010; Alvesson, Ashcraft and Thomas, 2008), with discourse being defined as:
“A way of reasoning with certain truth effects through its impact on practice, anchored in a particular vocabulary that constitutes a particular version of the social world.” (Sveningsson
and Alvesson, 2003:1171-1172)
Some critical management scholars see discourse, self-narratives, self-identity and role expectations as interwoven (Sveningsson and Alvesson, 2003) in which expectations are set about what constitutes a ‘model’ employee and its associated norms of behaviour. This “discursive regulation” as Elraz calls it (2013:37) affects how employees make sense of who they are and who they are not at work in relation to others (Sluss and Ashforth, 2007). Alvesson and Willmott (2002) argue that whether done purposefully or as a result of everyday interactions, discursive management practices, such as induction, training or promotion procedures shape self-identity at work and provide little room for resistance:
“The domination of managerially orchestrated identities implies limited space for critical reflection, places constraints upon ethical judgement and exerts a strong corporate grip over people’s lives.” (2002:636)
These dominant organizational discourses can create tensions between self-identity and organizational ideals and the extent to which employees have the freedom to shape their own identities within these discursive ‘controls’ (e.g. Alvesson and Wilmott, 2002; Elraz, 2013; McKenna, 2010). The personal trauma stories that are told in the present study, however, offer an opportunity for what Alvesson and Willmott call “micro emancipation” (2002:619), whereby these experiences may create a space in which counter-discourses can be projected so that participants can reconstruct their identities as a result.
In summary, this chapter has introduced the concept of growth through trauma and has surfaced the study aims and research question that guide the present study. It has also provided definitions of personal trauma and personal narratives and has connected personal narratives to growth through trauma research. The chapter ends by positioning the study within an organizational context by acknowledging that an individual’s experience of their organization is infused with expectations about the working self, which may affect the way individuals make sense of themselves at work. Personal narratives alone, however, are not a window into the world of personal change post-trauma. It is through the methodological approach that was applied to the four cases in the present study, that experiences could be interpreted and understood. However, before discussing the methodological approach that was adopted in this study, which is the focus of chapter three, it is important to review some of the qualitative empirical work within the field of post-traumatic growth through cancer and bereavement. This is the focus of the next chapter.
2.
SUMMARY OF THE QUALITATIVE LITERATURE
Given the research question that underpins the present study (How does the experience of
personal trauma affect the way managers view and approach their work and their
relationships at work?) and its narrative approach to inquiry, it is important to explore the
findings, limitations and gaps within existing qualitative empirical work in the field of growth through trauma research. Within this literature, coping is widely accepted as a mediator between trauma and growth (Carver, Scheier & Weintraub, 1989; Folkman & Moskowitz, 2004). There have been many coping strategies that are said to be adaptive. For example, problem-focused coping (e.g. focusing on tasks that may lead to potential solutions) (e.g. Sears, Stanton and Danoff-Burg, 2003; Widows, Jacobsen, Booth-Jones and Fields, 2005); emotion-focused coping (e.g. venting the emotions associated with suffering) (e.g. Antoni et al, 2001; Thornton and Perez, 2006); social-focused coping (e.g. drawing on support from an individual’s social network) (e.g. Schroevers, Helgeson, Sanderman and Ranchor, 2010); positive re-appraisal (e.g. re-framing to appreciate positive aspects such as family support) (e.g. Urcuyo, Boyers, Carver and Antoni, 2005); religious coping (e.g. using spiritual beliefs as a means of making sense of the experience) (e.g. Denney, Aten and Leavell, 2011); meaning-focused coping (e.g. finding meaning in volunteer work) (e.g. Davis, Nolen-Hoeksema and Larsen, 1998; Linley and Joseph, 2011); and benefit-reminding (e.g. reminding oneself of all the good things in life such as relationships with family and friends) (e.g. Affleck and Tennen, 1996).
In 2004, Linley and Joseph conducted a meta-review of all empirical work to date (i.e.
qualitative, qualitative and mixed method studies), and at that time, they identified 39 studies (excluding theoretical and literature reviews) that had empirically examined what they
collectively termed ‘adversarial growth’. Since then, the field has burgeoned. For the purposes of the present study, a Proquest search was conducted which included the databases PsycARTICLES and PILOTS (Published International Literature on Traumatic Stress) using the search terms “post-traumatic growth”; “stress-related growth” and ‘benefit-finding”. This search revealed 336 peer-reviewed journal articles, 30 books and 47 theses since 2000 alone; with 333 of these published works focusing on post-traumatic growth (PTG). This demonstrates the dominance of PTG as a construct within the literature.
In order to focus this search further, two search strings were used. The first search string sought to identify qualitative studies of growth through cancer, as two of cases in the present study (Edgar and Bill) are cancer narratives. The second search string focused on qualitative
studies of growth through bereavement, since the remaining two cases in the present study (Diane and Peter) are bereavement narratives.
In the absence of any meta-reviews that specifically explore post-traumatic growth following bereavement, the present search applied the inclusion criteria outlined by Hefferon, Grealy and Mutrie (2009) in their systematic review of the literature of post-traumatic growth
following life threatening illness. In their review, these authors focused on qualitative studies that explore the concept of post-traumatic growth and only included studies of adults (not children). They also excluded theses, reviews, commentaries, books and book chapters from their review. Their search of the literature identified 57 studies of growth following life
threatening illness; however the Hefferon et al (2009) review includes mixed method studies and trauma types other than cancer (such as HIV, rheumatoid arthritis and multiple
sclerosis). Given the focus of the present study and the volume of empirical work published to date, the present review focuses on studies of growth following cancer from 2000
onwards.
In their review of the literature, Hefferon et al (2009) identify nine studies to explore growth through cancer since 2000 using a purely qualitative approach (not mixed methods), which are outlined in Table 2.1. In order to locate additional empirical work, the present search used the terms “post-traumatic growth” AND “cancer” which identified a further 43 peer-reviewed articles. Seven were discounted, however, as they were PTG construct validation studies or literature reviews (e.g. Rajandram, Jenewein, McGrath and Zwahlen, 2011; Sumalla, Ochoa and Blanco, 2009; Sawyer, Ayers and Field, 2010). Of the 36 studies that remained, only three of them were purely qualitative in their approach (Denney, Aten and Leavell, 2011; Lelorain, Tessier, Florin and Bonnaud- Antignac, 2012; Wong, Cavanaugh, MacLeamy, Sojourner-Nelson and Koopman, 2009). The review presented here therefore builds on the nine studies identified by Hefferon et al (2009) with the addition of three further studies of growth following cancer (see Table 2.1).
Bereavement on the other hand is a trauma type that has been less frequently studied (Smith, Joseph and Das Nair 2011:413). It is therefore unsurprising that the second search string using the terms “post-traumatic growth” AND “bereavement”; “post-traumatic growth” AND “bereaved”; and “post-traumatic growth” AND “loss”, revealed only 13 peer reviewed articles since 2000 (Armstrong and Shakespeare-Finch, 2011; Boyraz and Efstathiou, 2011; Cadell, and Sullivan, 2006; Currier, Mallot, Martinez, Sandy and Neimeyer, 2011; Davis, Wohl and Verberg, 2007; Engelkemeyer and Marwit, 2008;Glaser, Bucher, Moergeli, Fauchère and Buechi, 2007; Ho, Chu and Jiu, 2008; Murphy, Johnson and Lohan, 2003;
Parappully, Rosenbaum, van den Daele and Nzewi, 2002; Smith, Joseph and Das Nair, 2011; Taku, Calhoun, Cann and Tedeschi, 2008; Wolchik, Coxe, Tein, Sandler and Ayers, 2008). Of these studies, only two are purely qualitative in their approach (Glaser et al, 2007; Smith et al, 2011) with a further four drawing on mixed methods (Cadell, and Sullivan, 2006; Davis et al, 2007; Murphy et al, 2003; Parappully et al, 2002) (see Table 2.2). The remaining seven studies appear to follow the dominant ontological paradigm in this field by adopting a quantitative approach, with the aim being to measure or predict the variables which support or inhibit growth at an individual, dyadic, group or societal level. Within these studies, post-traumatic growth is measured using the Post-post-traumatic Growth Inventory (PTGI) (Tedeschi and Calhoun, 1996), which measures self-reported growth across five domains. These are: personal strength; new possibilities; relating to others; appreciation of life; and spiritual change. A brief explanation of each of these domains now follows:
1. Personal strength
This is a recognition that ensues in individuals regarding their ability to deal with adversity and their belief that they possess more skills and strengths compared to a pre-trauma self (Lindstrom et al, 2013).
2. New possibilities
This is the discovery by an individual of a new life path or a new philosophy on life that was not present before the trauma (Tedeschi and Calhoun, 1996; 2004).
3. Relating to others
This relates to feelings of closeness and intimacy in interpersonal relationships; increased self-disclosure; greater emotional connection with others and the recognition that since their trauma some social networks have become more meaningful while others have been weakened or ended (Tedeschi and Calhoun, 2004).
4. Appreciation of life
This concerns a reported change in life priorities as a result of trauma and a greater
appreciation of the small things in life, such as the colour of the sky (Shakespeare-Finch and Barrington, 2013).
5. Spiritual change
This concerns the use of faith as a coping mechanism during trauma and the spiritual growth that is reported as a result (Denney et al, 2011)
To date, none of the previous studies to explore growth following cancer or bereavement appear to have drawn on biographic narratives, despite the suggested link between
Table 2.1: Qualitative studies of post-traumatic growth through cancer (adapted from Hefferon et al, 2009)
Author(s) and year Sample and focus of study Method Domains of growth
1. Arman, Rehnsfeldt Lindholm, and Hamrin (2002)
Understanding the experiences of four women with breast cancer in Finland Four semi-structured interviews at admission, 3, 6 and 12 months Phenomenology Personal strength Relating to others Authentic self
2. Coward and Kahn (2005)
Exploration of experiences of transcendence among 14 American women with newly diagnosed cancers
Three semi-structured interviews across an eight-month period post-diagnosis Interpretative Phenomenological Analysis (IPA) Appreciation of life Relating to others New possibilities (to work less)
Personal strength Increased spirituality Humility
Increased empathy Desire to ‘give back’ 3. Denney, Aten and
Leavell (2011)
Understanding how cancer affects the spiritual growth of 13 cancer survivors in the US
Focus groups Semi-structured interview Phenomenology
Spiritual growth across five domains and additional areas of growth in evangelism and enhanced spirituality of family and friends 4. Eide (2007) Exploration of 11 Hawaiian women’s experiences of surviving breast
cancer Open interview Interpretative Phenomenological Analysis (IPA) Relating to others Appreciation of life New possibilities Increased spirituality Increased empathy Wanting to ‘give back’ 5. Johansson,
Holmström, Nilsson, Ingvar, Albertsson and Ekdahl (2003)
Exploration of experiences of arm lymphoedema following breast cancer among 12 women in Sweden
Semi-structured interview Phenomenology
6. Lam and Fielding (2003)
Understanding the breast cancer experiences of 17 women in China Semi-structured interview Phenomenology
Appreciation of life Relating to others 7. Lelorain, Tessier,
Florin and Bonnaud- Antignac (2012)
Understanding positive changes in long-term survivors of breast cancer among 28 women in France
Open interviews Appreciation of life Personal strength Relating to others Reported ‘Janus-faced’ growth 8. Luoma and Hakamies-Blomqvist (2004)
Exploration of the meanings and quality of life of advanced stage breast cancer among 25 women in Finland
Semi-structured interview Appreciation of life Personal strength Increased empathy 9. Morris,
Shakespeare-Finch and Scott (2012)
Exploration of the experiences of 209 Australian cancer survivors three years post-diagnosis
Written cancer narratives
Appreciation of life Relating to others
New found compassion for others
Health-related changes 10. Parry and Chesler
(2005)
Exploring meaning-making, increased spirituality and thriving among 50 childhood cancer survivors three years post-diagnosis
Semi-structured interview Appreciation of life Relating to others Personal strength New possibilities Need to ‘give back’ Increased empathy 11. Winterling, Wasteson,
Glimelius, Sjorden and Nordin (2004)
Experiences of 14 advanced cancer patients and their spouses following diagnosis (Sweden) Semi-structured interview Phenomenology Appreciation of life Relating to others 12. Wong, Cavanaugh, MacLeamy, Sojourner-Nelson and Koopman (2009)
Exploration of the long-term impact of having a parent diagnosed with cancer among 27 adults in the US
Semi-structured interview Appreciation of life Relating to others Reported ‘Janus-faced’ growth
Table 2.2: Qualitative studies of post-traumatic growth through bereavement
Author(s) and year Sample and focus of study Method Domains of growth
1. Cadell and Sullivan (2006)
Exploration of post-traumatic growth and bereavement among 174 bereaved caregivers of people with HIV/AIDS in Canada
174 survey respondents 15 semi-structured interviews Spirituality New possibilities Relating to others Personal strength Appreciation of life 2. Davis, Wohl and
Verberg (2007)
An exploration of post-traumatic growth among 52 bereaved adults following a mining explosion in Nova Scotia
Open and closed interviews and questionnaire Appreciation of life Relating to others Personal strength ‘Janus-faced’ growth 3. Glaser, Bucher, Moergeli, Fauchère and Buechi (2007)
An exploration of the experiences of 10 mothers and 9 fathers who lost a premature baby (Switzerland)
Semi-structured
interviews at 6 month, 3.5 years and 6.5 years post loss
Relating to others (feelings of closeness to partner and feeling supported by family / friends / professionals) 4. Murphy, Johnson and
Lohan (2003)
Finding meaning in a child’s violent death. A exploration of 138 parental narratives 4, 12, 24 and 60 months after death
Written narratives and questionnaire
Spirituality
Relating to others (support group attendance)
5. Parappully,
Rosenbaum, van den Daele and Nzewi (2002)
A study of the experience of 16 US parents of murdered children Semi-structured interviews and questionnaire Increased compassion Relating to others Spirituality Personal strength 6. Smith, Joseph and
Das Nair (2011)
An interpretative phenomenological study of 6 bereaved adults by suicide Semi-structured interview Phenomenology Appreciation of life Personal strength Relating to others Social context
Tables 2.1 and 2.2 present a summary of the qualitative literature on growth following cancer and bereavement. These tables contain four columns; the author(s) and year of study; a brief description of the study sample and the focus of the study; the methods of data collection; a summary of the domains of growth reported by participants in the study. There are some common themes to emerge from these studies, which is the next focus of discussion.
2.1
Growth through cancer
One of the most commonly reported domains of growth in qualitative studies of cancer (as outlined in Table 2.1) is strengthened relationships with family and friends (Arman et al, 2002; Coward and Kahn, 2005; Eide, 2007; Lam and Fielding, 2003; Morris et al, 2012; Parry and Chesler, 2005; Winterling et al, 2004). Other reported growth dimensions include;
wanting to work less and to enjoy home life more (Coward and Kahn, 2005); increased spirituality (Denney et al, 2011); and increased feelings of compassion and empathy (Morris et al, 2012; Coward and Kahn, 2005; Eide, 2007; Luoma and Hakamies-Blomqvist , 2004; Parry and Chesler, 2005). In some of these studies, behavioural change is reported in participant’s descriptions of wanting to ‘give something back’ as a result of their illness experience (Coward and Kahn, 2005; Eide, 2007; Parry and Chesler, 2005).
As is common across some of the bereavement studies that are summarised next, the contradictory nature of growth emerges in two of the qualitative studies of growth through cancer (Lelorain et al, 2012; Wong et al, 2009). Maercker and Zoellner (2004) called this aspect of PTG ‘janus-faced’, by which they mean that there may positive and negative elements that coexist during the coping and growth process. An illustration of this in the Lelorain et al (2012) study, is the theme of “people around: support and stress” (2012:632), in which women describe feelings of support alongside a sense of responsibility not to burden their family or friends, which is reported as an additional strain when coping with cancer.
Within the many quantitative studies of cancer to date (for a review, see Stanton, Bower and Low, 2006) there is some debate as to the variables that affect coping and growth. For example, results are mixed when it comes to the relationship between age and reported growth. For example, some studies show younger people deriving more benefit than older adults (e.g. Manne, Ostroff, Winkel, Goldstein, Fox and Grana, 2004). This may be because they have more of their life ahead of them, so they are more motivated to take a positive stance as regards their illness. Equally, findings from quantitative cancer studies which examine growth at different time points from diagnosis also yield mixed results. One of the
few longitudinal studies (Manne et al, 2004) showed that over an 18-month period, women with breast cancer reported significant increases in PTGI scores. Conversely, in an early study of critical illness, Affleck, Tennen & Croog (1987) found reports of growth to be stable over an eight-year period.
The relationship between disease severity and reported growth has also been explored, with some interesting findings. In a study by Lechner, Zakowski, Antoni, Greenhawt, Block, and Block (2003), for example, the lowest level of growth was reported by cancer patients at the most advanced stage of the disease, which indicates that there may be an optimal level of distress that promotes growth, beyond which, a person may become overwhelmed and growth is impeded (Stanton et al, 2006).
Several coping strategies have been found to be adaptive in cancer studies, such as seeking social support from someone who has come through the illness (Rajandram, Jenewein, McGrath, and Zwahlen, 2011). Equally, the extent to which people express emotions associated with their illness, such as venting frustrations to supportive partners is also associated with growth (Thornton and Perez, 2006). Other coping strategies that have been connected to reports of growth following cancer include positive re-appraisal, that is to say, looking to make the best of the situation (e.g. Sears, Stanton and Danoff-Burg, 2003).
2.2
Growth through bereavement
One of the reasons that there may be fewer studies of growth through bereavement is that it appears different to other trauma types. This may be because, unlike an illness from which someone can recover, the sense of loss that comes with bereavement remains with an individual for life. As Tedeschi and Calhoun (2008) explain:
“For most people loss is always an issue, and that missing loved ones and remaining connected to them is part of the bereaved person’s experience throughout life” (2008:28)
In the context of coping with the loss of a child specifically, some qualitative studies of growth through bereavement cite the importance of relating to others who can provide formal and informal support (Glaser et al, 2007; Murphy et al, 2003; Parappully et al, 2002). During the grieving process, Aldwin, Sutton and Lachman (1996) found that coping flexibility is required, as people draw on all types of coping strategies, which suggests that coping with
bereavement may be one of the most complex trauma types to deal with, especially in a young or indiscriminate death (Murphy et al, 2003; Parapully et al, 2002).
Znoj (2006) suggests that in bereavement studies, the ‘janus-faced’ (Maercker and Zoellner, 2004) nature of growth is emphasised where the growth processes can be contradictory. In some studies for example, despite reporting positive change, people who have been bereaved also report an inability to make sense of what has happened (e.g. Davis et al, 2007). Some quantitative studies of bereaved parents have shown that negative coping strategies such as denial are drawn on in the short-term to them cope in the immediate aftermath of the death of a child (e.g. Znoj and Keller, 2002). In other studies, despite searching for meaning, the loss is never accepted (Tedeschi and Calhoun, 2008). In this regard, some studies show that the experience of growth following bereavement emerges only after a struggle to come to terms with the loss (Tedeschi and Calhoun, 2008) and that growth can co-exist alongside psychological distress (e.g. Lev-Weisel and Amir, 2003), which suggests that the relationship between post-traumatic growth and distress is not mutually exclusive.
In a longitudinal study of people dealing with the death of a family member, Davis et al (1998) found that people experienced a two stage-process of growth, by first ‘making sense’ of the loss and then ‘finding benefit’ in the experience. This is similar to the ‘schema-change’ Janoff-Bulman (2006) speaks of when individuals re-build a sense of themselves and the world following trauma, particularly through a story of their loss in a post-traumatic growth narrative (Neiymeyer, 2006).
When it comes to the organizational contexts in which these studies have taken place, there does not appear to be any studies to date of growth following cancer or bereavement within the context of ‘everyday’ workplaces. This has been identified as a gap in the literature (Maitlis, 2012). The few studies that have explored post-traumatic growth in the context of work have focused on vicarious or secondary growth among ‘trauma workers’ (Cohen and Collens, 2012) in ‘extremis’ settings (Kolditz and Brazil, 2005), that is to say organizational contexts in which exposure to trauma is commonplace (e.g. disaster recovery work; emergency services or the military). Despite their contextual differences, there may be opportunities to apply knowledge from studies of growth among trauma workers to ‘ordinary’ places of work.
2.3
Growth among trauma workers
Paton (2006) identifies four types of ‘extremis’ workplace; ‘trauma organizations’ (e.g. hospital emergency departments); ‘critical action organizations’ (e.g. the military); ‘high reliability organizations’ (e.g. high-security prisons); and ‘naïve organizations’ (such as a
business in one of the twin towers pre-9/11). Most of the research into growth through trauma at work has taken place in ‘trauma’ or ‘critical action’ settings (Hannah, Uhl-Bien, Avolio and Cavaretta, 2009) with a gap in the literature that has been identified in ‘naïve’ or ‘ordinary’ organizations (Maitlis, 2012). Within these ‘trauma’ and ‘critical action’ settings, research has taken place among therapists (e.g. Arnold, Calhoun, Tedeschi and Cann, 2005; Lonergan, O'Halloran and Crane, 2004; Pistorius, Feinauer, Harper, Stahmann and Miller, 2008); medics (e.g. Bauwens and Tosone, 2010; McLean, Handa, Dickstein, Benson, Baker, Isler, Peterson and Litz, 2013); disaster recovery workers (e.g. Linley and Joseph, 2006);
protective services personnel (e.g. Paton, 2005); emergency services professionals (e.g. Shakespeare Finch, Smith, Gow, Embleton and Baird, 2003; Shakespeare-Finch, Gow and Smith, 2005) and interpreters (e.g. Splevins, Cohen, Joseph, Murray and Bowley, 2010). Despite their contextual differences, there may be knowledge that can be transferred from these studies to the contexts of ‘ordinary’ work.
Studies of PTG among trauma workers have identified certain coping strategies as helpful when dealing with the psychological impact of their work. For example, after exposure to trauma, if workers have an opportunity to share the emotions they are experiencing with colleagues, this has been found to be helpful (Shakespeare-Finch et al, 2003). Drawing on the support of family or friends outside work; or ‘switching off’ from work through leisure activities, such as exercise, meditation or watching films, has also been found to be beneficial (Splevins et al, 2010).
In their meta-review of the trauma worker literature, Cohen and Collens (2012) propose that trauma workers experience vicarious growth by “empathically engaging” (2012:8) with the traumatized. These authors suggest that four growth themes are evident across the
literature, which are all contradictory in nature. These are; ‘changes to world views’; ‘changes to values’; ‘changes to self’ and ‘changes to everyday life’. In ‘changes to world views’, for example, Cohen and Collens (2012) report that on the one hand trauma workers report an increased appreciation of life (i.e. their work helps them to put things into perspective by trivialising their own struggles); whilst at the same time, they report feeling that the world is less safe, because of the types of experiences they are exposed to (Lonergan et al, 2004). In ‘changes to values’, trauma workers report both closer and more distant ties with friends and family as a result of their work (Splevins et al, 2010). In ‘changes to self’, some workers report feeling more compassionate towards others, while others report feeling less
some workers report heightened self-awareness, wisdom and increased competence, whilst some report feeling more vulnerable as a result of their work (Lonergan et al, 2004; Pistorius et al, 2008; Splevins et al, 2010).
One of the benefits of the research that has been conducted among trauma workers to date is that it provides an opportunity to examine the role of the organization in supporting or hindering individual workers. As Cohen and Collens (2012) argue:
“There is evidence to indicate that organizations could be instrumental in assisting employees… through the provision of institutional support” (2012:8)
Some studies suggest that organizational culture and working practices are important, such as fostering of a culture of respect and support where open and honest conversations are encouraged (Rourke, 2007). Other studies suggest that organizations can support individual trauma workers by making counselling, peer supervision and de-briefs available (Pistorius et al, 2008; Splevins et al, 2010). Organizations have an opportunity to help their employees to interpret their experiences in a way that supports individual learning and organizational development. In this regard, Paton (2006) argues that training is a way of facilitating meaning-making from trauma experiences:
“From the perspective of emergency professions, the existence of a learning component in the process of PTG is particularly important. It means that once the resources and processes associated with growth are identified, attention can be directed to exploring how these
competencies can be developed and sustained.” (2006:227)
Paton (2006) argues that there are ways which organizations can collectively learn, such as through post-event support which encourages employees to recount their interpretations of the trauma experience to build shared understanding. Some scholars suggest that one of the most important factors regarding the recovery of emergency services professionals to
traumatic events is a caring organizational culture (Alexander, Klein and Bowes, 2000; Alexander & Klein, 2002), which others have suggested includes open and honest
communication, mutual support and regular post-event reviews (Paton, 2006; Pistorius et al, 2008; Splevins et al, 2010). Some of these ideas are revisited again in chapter 9 when discussing the practical implications of the present study.
2.4
Areas of convergence
Within the extant literature, there appear to be four areas of convergence. Firstly, despite not being the focus of this doctoral study, the literature suggests that coping and growth are linked to individual dispositions (e.g. optimism; Affleck and Tennen, 1996; Carver, 1998; Sears et al, 2003; Shakespeare-Finch et al, 2005).
Secondly, there are three domains of growth that appear to pervade the literature of both direct and vicarious growth through trauma (Joseph, 2009). Firstly, people report that their relationships with others have changed in some way, such as an increased sense of compassion. Secondly, individuals report a changed sense of self, such as a greater self-awareness or a sense of personal strength. Thirdly, individuals report changes in life philosophy, such as gaining a new perspective on the important things in life.
The third area of convergence appears to hinge on the importance of coping flexibility. By “finding their own way to deal with it” (Splevins et al, 2010:1711), this may mean that negative paths to growth are followed, that is to say that some people may use negative coping strategies to ‘get them through’ in the short term, which are then superseded by adaptive coping and growth (Znoj, 2006). Equally, the literature suggests that by reporting growth this does not mean the absence of distress. As Grubaugh and Resick explain:
“It is not impossible to conceive that individuals may report some gains as a result of their trauma while still experiencing significant distress. That is, both growth outcomes and psychopathology can co-exist. Significant distress could in fact motivate a subset of individuals to create meaning from their experiences that helps to balance out the losses they have experienced.” (2007:153)
Finally, research has indicated that in trauma settings organizational factors, such as a culture of honesty, respect and open communication (e.g. Rourke, 2007); and support structures, such as the provision of counselling and peer supervision (e.g. Pistorius et al, 2008; Splevins et al, 2010) are important in helping trauma workers to grow from trauma.
There appears to be some limitations in the literature to date, as well as to the concept of post-traumatic growth itself. In the literature, these limitations centre on an overreliance on self-reports of growth; the directionality of change; and issues of when growth is assessed. Furthermore, as Maitlis (2012) points out, there is a gap in the literature when it comes to
exploring post-traumatic growth in the context of ‘everyday’ workplaces. In the next section, these limitations are discussed and addressed in relation to the present study.
2.5
Critiquing the literature
There have been challenges levelled against empirical work to date including criticisms of the PTG framework itself. Some scholars argue that there is an over-reliance on self-reporting (Linley and Joseph, 2004) which may have led to subjective assessments of growth. Researchers have called for more objective indicators of growth to be included in future research, such as behavioural observation, which may be easier than trying to examine internal feelings or belief systems (Shakespeare-Finch and Barrington, 2012). Equally, research has suggested that growth cannot occur without action (Hobfoll et al, 2007). The PTG framework itself prioritises cognitive processes (see Figure 1.1), such as rumination, as opposed to exploring cognitions and behaviours post-trauma. Furthermore, despite some recent research into the relationship between sociocultural influences and PTG (Lindstrom et al, 2013), the framework appears to be context free, that is to say, there is no explicit
reference to the contexts in which growth occurs. The present addresses these concerns by focusing on the trauma stories as told by the individual themselves, as well as drawing on third party accounts from their nominated workplace witnesses. Consequently, the self-reported behaviour change at work that is self-reported by participants in the present study is also independently observed by their workplace witnesses.
There appears to be scepticism among researchers as to whether reports of growth reflect genuine change or whether they are illusions to help people cope (Frazier, Tennen, Gavian, Park, Tomich and Tashiro, 2009; McFarland and Alvaro, 2000). Other, similar questions have been raised about the extent to which reports of growth are a way of adhering to cultural norms, that is to say, people report growth because they believe society expects them to make the best of a bad situation (Linley and Joseph, 2004; Park and Lechner, 2006). Again, the present study addresses these issues through the third party ‘witness’ accounts, which provide evidence of change as observed by colleagues around them at work.
Problems of recall are also raised when it comes to studies of growth through trauma, where retrospective accounts can be seen as reflections of what someone chooses to remember after the event, and momentary accounts are descriptions ‘in the moment’, during or immediately after the trauma has taken place (Folkman and Moscowitz, 2004). Since this study is not looking to uncover ‘fact’ or ‘truth’, but instead seeks to understand individual